Christian counseling: Nouthetic vs. Biblical

Last night, I spent some time on the phone with my husband’s friend’s sister (aka my former pastor’s sister). We’ll call her Natalie.

Natalie was very sweet and kind, really encouraging and strengthening me by sharing her testimony of faith in God. She suffers from anxiety and panic attacks, which has led her to take Paxil (on and off) for the past 7 years. She says the drug has helped her tremendously and who am I to knock the drug (knowing what I know about Paxil/Seroxat) when she has seen the wonders that it has worked in her life?

I briefly explained my story of depression, history of suicide, and diagnosis of bipolar disorder. Although she couldn’t fully relate, she was very sympathetic and understanding. In fact, our conversation was so fruitful, I ended up taking notes!

Jay AdamsWe briefly touched on the issue of Nouthetic counseling (NC). She has undergone the course and simply needs to be certified. The counselor I currently see is associated with the Christian Counseling Education Foundation (CCEF), which has roots in NC and was founded by the man—Jay Adams—who developed the method. However, CCEF is now known for what is called biblical counseling. The organization has since moved away from pure Nouthetic methods and become more a bit more varied, taking bits and pieces of psychology (and perhaps psychiatry) that line up with the Bible. Adams, disagreeing with the organization’s approach, founded the Institute for Nouthetic Studies and uses the Bible as the sole counseling textbook. According to the wiki entry on Nouthetic counseling, Adams developed the word Nouthetic based on the “New Testament Greek word noutheteō (νουθετέω), which can be variously translated as ‘admonish,’ ‘warn,’ ‘correct,’ ‘exhort,’ or ‘instruct.'”

NC was developed back in the ’70s as a response to the popularity of psychology/psychiatry. Many Christians reject some of the teachings of such popular psychologists as Freud, Jung, Adler, Maslow, etc. Adams’ highly successful book, Competent to Counsel, criticizes the psychology industry and counters its teaching with a Nouthetic approach.

But NC has its Christian critics.

Continue reading “Christian counseling: Nouthetic vs. Biblical”

Loose Screws Mental Health News

The mastermind behind Stavzor is Noven Pharmaceuticals (in conjunction with Banner Pharmacaps Inc.). The new “small, easy-to-swallow soft gel capsule” is available in three strengths: 125, 250, and 500 mgs. The pills are are “up to 40% smaller than han Depakote® and Depakote ER® tablets at the 500 mg dosage strength.” From Noven’s PR:

Stavzor is approved for the treatment of manic episodes associated with bipolar disorder, as monotherapy and adjunctive therapy in the treatment of patients with complex partial seizures that occur either in isolation or in association with other types of seizures, and for prophylaxis of migraine headaches.

The drug will hit the market in mid to late August.

The hotline receives an average 250 calls each day from veterans that have fought in Iraq, Vietnam, and Afghanistan.

The issue of soldiers with mental illness has recently come to light with studies showing that 1 in 5 soldiers returning from Iraq and Afghanistan have shown symptoms of post-traumatic stress disorder. The issue of the high suicides rate has been a high priority of the VA since mental health director Ira Katz tried to hide the significant number of suicides committed by veterans.

The National Suicide Prevention Lifeline is available 24 hours a day by calling 800-273-TALK (8255); veterans should press “1” after being connected.

“We have seen a 60 per cent increase in demand for our child anxiety classes in the past six months,” said [Dr. Kimberley O’Brien, of the Quirky Kids Clinic at Woollahra in Sydney].

It sounds more like the article is speaking of children who are exposed to constant physical and emotional abuse. If that’s the case, shouldn’t there rather be an increase in parenting properly classes?

2-Year Anniversary: The Long and Winding Road

I’m aware that my blog has taken a significantly dark turn.  This may alienate some of my readers who seek happier, brighter topics. I don’t think my posts have been negative; on the contrary, I think they’ve been positive. Positive and educational.

I’ve been exploring the topic of suicide recently because it’s a subject that’s quite near and dear to me, now more than ever before.

Continue reading “2-Year Anniversary: The Long and Winding Road”

Former Fox News employee suffers from PTSD as a result of bedbugs in the office

This story is sort of sad and wacky at the same time:

A Fox News employee who says she suffers from post-traumatic stress disorder after being bitten by bedbugs at work filed a lawsuit on Thursday against the owner of the Manhattan office tower where she worked.

Jane Clark, 37, a 12-year veteran of Fox News, a unit of News Corp, said she complained to human resources after being bitten three times between October 2007 and April 2008. She said she was ridiculed and the office was not treated for months.

When I first saw that, I thought to myself, give me a break. Then I read:

Clark says she suffers nightmares and keeps a flashlight at her bedside so she can check for bugs during the night.

Suddenly, sympathy hit me. I’m incredibly scared of bugs in general so the thought of bedbugs crawling around in an office and then bringing it home would scare me like crazy. I had enough of a brief PTSD stint after some guy crept into my psych hospital room and began masturbating while he thought I was asleep. Thank God he didn’t rape me.

After coming home from the hospital, I couldn’t sleep with the lights off. My husband, who doesn’t sleep well with the light on, was kind enough to let me leave them on for about a week or so while I slowly got over the whole ordeal. But it took about a month or two before I could get up in the middle of the night by myself before I was convinced that a dark figure making grunting noises wouldn’t be standing next to my side of the bed or lurking in the bathroom or dark hallways of the apartment. For a few weeks, I made my husband escort me to the restroom — I was that scared.

So instead of my initial reaction of rolling my eyes to this story, my heart goes out to Ms. Clark. I always do a spot check of beds anytime I stay at a hotel. I can’t imagine the thought of bringing them home. I get freaked out enough as it is when I find one spider or stinkbug in the apartment.

I’d sleep with the lights on all over again.

Loose Screws Mental Health News

John Grohol at PsychCentral reports that the fate of the mental health parity bill is uncertain as its main champion, Sen. Ted Kennedy, takes a leave of absence to focus on treatment of his brain tumor. I echo John’s thoughts in hoping to see that other senators are willing to carry the torch and pass this important piece of legislation.


I came across a post from Kalea Chapman at pasadena therapist in which she linked to a WSJ article on whether veterans suffering from PTSD should be awarded the Purple Heart.

Supporters of awarding the Purple Heart to veterans with PTSD believe the move would reduce the stigma that surrounds the disorder and spur more soldiers and Marines to seek help without fear of limiting their careers.

Opponents argue that the Purple Heart should be reserved for physical injuries, as has been the case since the medal was reinstituted by Congress in 1932.

I side with the opponents. The Purple Heart should be awarded to be people who have visible evidence of bravery. With the rising number of PTSD prevalence, I’m afraid that the award would be handed out like candy. The rising number of veterans with PTSD on disability has caused enough of an issue that a Texas VA facility wanted mental health officials to stop diagnosing veterans with the condition.


Jordan Burnham, an 18-year-old student who survived a nine-story jump from a building, plans on walking at his graduation with the assistance of two canes. A family who used to attend my church knows this family and put him on my church’s prayer list. It’s a small world, after all.


Finally, it looks like expecting moms should have no fear of causing birth defects in their baby while taking antidepressants, according to a study being published in the British Journal of Psychiatry.

A research team from Montreal University studied more than 2000 pregnant women on antidepressants and discovered the drugs did not present any adverse effects. However, it sounds like they only oversaw the women while they were pregnant in their first trimester. I haven’t seen the actual study but it doesn’t seem to mention whether the women discontinued the antidepressants after the first trimester.

Loose Screws Mental Health News

Call me old-fashioned (I am 26 after all; that's 62 in technology years) but I don't like the idea of putting my personal health records online. Google Health has just launched in an attempt to rival Microsoft's Revolution Health. GH's site appears way more personalized than RH and the idea of uploading medical records doesn't thrill me. GH has features where you can put in the "general" information people don't mind giving out (ie, height, weight) and personalize the diseases, disorders, or conditions you might suffer from (somewhat like WebMD). This is about as far as I would go in using the site. No way would I upload a PDF from my doctor with my name, address, social security number, and health insurance information on the a site — I don't care HOW secure. Medical identity theft is a reality now and the last thing I need to worry about is some idiot hacker stealing people's medical records online. We already have enough problems with people stealing VA SSNs.

On the topic of health, the AP is reporting that an estimated 300 to 400 doctors commit suicide every year — a rate that rivals that of the general population. (Hat tip: GP Essentials)

As for the VA, the news keeps on getting better and better. The Washington Post reports that psychologists at VA facilities are being told to keep their PTSD diagnoses to a minimum so the VA can stem the tide of veterans seeking disability payments for the condition. Depending on the severity of the disorder, veterans can receive up to a little more than $2500 per month. Norma Perez, PTSD coordinator for a Texas VA facility, sent an internal e-mail to mental health and social workers saying:

Given that we are having more and more compensation seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out."

Instead, she recommended that they "consider a diagnosis of Adjustment Disorder."

VA staff members "really don't . . . have time to do the extensive testing that should be done to determine PTSD," Perez wrote.

The Post quotes psychiatrist Dr. Anthony T. Ng who says that "adjustment disorder is a less severe reaction to stress than PTSD and has a shorter duration, usually no longer than six months." This means less payout for the VA.

After the e-mail went public, VA Secretary Jim Peake issued a statement saying that Perez "has been counseled" and "is extremely apologetic." Of course. She has to be. She still has a job. (Credit to Kevin M.D.)

Mental illness trend on the rise among troops

soldierThe AP is reporting that nearly one in every five soldiers who have been part of the war in Iraq and Afghanistan now suffer from clinical depression and/or post-traumatic stress disorder (PTSD).
The researchers said 18.5 percent of current and former service members contacted in a recent survey reported symptoms of depression or post-traumatic stress. Based on Pentagon data that more than 1.6 million have deployed to the two wars, the researchers calculated that about 300,000 are suffering mental health problems.

“There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan,” said Terri Tanielian, the project’s co-leader and a researcher at Rand. “Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation.”

The trend of mental illness on the rise among soldiers isn’t a new story. I’ve written about the problem several times here, here, and here. The real question now is how the problem is being addressed.

Veterans Affairs is responsible for care of service members after they have leave the military. The Defense Department covers active duty and reservist needs.

Col. Loree Sutton, who heads a new Pentagon center on brain injury, said the Rand study will add to the work defense officials are doing. That includes researching best practices used inside the military and out, improving and expanding training and prevention programs, adding mental health staff and trying to change a military culture in which many troops are afraid or embarrassed to get mental health treatment.
“We’ve got to get the word out that seeking help is a sign of strength,” Sutton said.

She said officials have been working to add thousands more mental health professionals to help the uniformed psychiatrists, psychologists and others struggling to meet the wartime demands of troops and their families. Across the services, officials are trying to hire over 1,000 additional staff. Also, companies providing health care by contract to the Pentagon have added over 3,000 in the past year, and the U.S. Public Health Service has provided some 200, she said. Veterans Affairs has added some 3,800 professionals in the past couple of years, officials there said.

It sounds like the VA is doing all they can with what they’ve got at the moment to address this problem. According to the article, the hesitation among troops to seek help is slowly and steadily on the decline. That’s a good sign. However, a few impediments that can block this progress:

  • they worried about the side effects of medication,
  • they believed family and friends could help them with the problem, or
  • they feared seeking care might damage their careers.

Again, I think many of these problems stem from psychological issues and should be heavily addressed by psychologists who are specifically trained help them work through these problems. This is one instance where I would downplay the use of psych drugs and focus primarily on talk (CBT/DBT/counseling) therapy.

Loose Screws Mental Health News

The AP has reported that a new Army mental health study says soldiers in Afghanistan have been suffering from an increase in depression in correlation with an increase in violence. It’s interesting that the focus is turning to Afghanistan now that violence has decreased in Iraq.

“The annual battlefield study found once again that soldiers on their third and fourth tours of duty had sharply greater rates of mental health problems than those on their first or second deployments, according to several officials familiar with the report.”

It seems that the more soldiers are exposed to combat, the higher the risk of depression and other mental health illnesses. A 2004 study indicates that about one in 10 soldiers have a serious mental health illlness that requires treatment. The AP article mainly focuses on depression but also mentions the rates of anxiety and PTSD are similar to the rates found in soldiers in Iraq last year. Thankfully, the number of troops who sought treatment has decreased to 29 percent from 34 percent in 2006.


TwinsOn a happy note (pun intended), a study published in Psychological Science has discovered that happiness can be genetic. Researchers studied about 1,000 identical and fraternal twins and found that their genes control about half of the traits that make people happy. The other half is control by circumstances.

“People who are sociable, active, stable, hardworking and conscientious tend to be happier, the researchers reported in the journal Psychological Science.

People with positive inherited personality traits may, in effect, also have a reserve of happiness to draw on in stressful times, [Tim Bates, a researcher at the University of Edinburgh who led the study] said.

“An important implication is that personality traits of being outgoing, calm and reliable provide a resource, we called it ‘affective reserve,’ that drives future happiness” Bates said.”

Basically, if you have none of those traits, you’ll just have to suffer through unhappiness like the rest of us. [sarcasm]


Finally, for those of you married men out there, here’s a tip to be a happier husband: Do more around the house, get more sex. ‘Nuff said.

(Image from Jupiter Images)

Mental Health Problems Among Soldiers and Veterans

I stumbled upon rawstory.com where I read about a report that CBS released detailing that suicide among veterans is double that of non-veterans. The Department of Veteran Affairs (VA) estimates that 5,000 veterans will commit suicide this year. Actually, the wording verbatim is "5000 suicides among veterans can be expected this year. It's sad that we've come to the point where we expect veterans to just kill themselves.

The Red State blog highlighted a notable quote from the story:

It found that veterans were more than twice as likely to commit suicide in 2005 than non-vets. (Veterans committed suicide at the rate of between 18.7 to 20.8 per 100,000, compared to other Americans, who did so at the rate of 8.9 per 100,000.)

One age group stood out. Veterans aged 20 through 24, those who have served during the war on terror. They had the highest suicide rate among all veterans, estimated between two and four times higher than civilians the same age. (The suicide rate for non-veterans is 8.3 per 100,000, while the rate for veterans was found to be between 22.9 and 31.9 per 100,000.)
I'll reiterate the obvious that everyone's been stating: Something needs to be done.
In general, the rate for veterans needs to significantly decrease, but I find the rate of suicide in the 20-24 age group alarming.
What's the disconnect between that age range as opposed to the other age ranges?
The issue here that needs to be addressed is psychological effects from the war resulting in post-traumatic stress disorder (PTSD).
While I'm sure that psychiatric assistance may come into play for some veterans, all veterans should receive counseling and therapy.
We'll see how the VA handles this information going forward.

In a related matter, USA Today published an article, based on an Army study in the Journal of the American Medical Association, detailing how duty in Iraq affects Army and National Guard soldiers.

The mental toll of fighting in Iraq affects 20% of active-duty soldiers and 42% of National Guard troops and reservists, according to an Army study, which also found that most mental health problems didn't surface until months after troops returned home.

Army psychiatrists examined the results of routine health screenings administered to nearly 90,000 soldiers – active-duty, National Guard and reservists – returning from Iraq in 2005 and 2006. They found about 25,000 suffering mental health problems, ranging from post-traumatic stress disorder (PTSD) and depression to substance abuse and family conflict, according to the study published Wednesday in the Journal of the American Medical Association.

The study also found that mental health problems did not surface as the soldiers left Iraq, but rather, that they appeared about three to six months after a tour of duty. Considering that soldiers are no longer in an unfamiliar area where their top concern is their safety, the appearance of mental health issues upon returning to the U.S. should be of no surprise.

One problem uncovered by the study was the Army's difficulty in treating alcohol abuse. Out of nearly 7,000 soldiers who admitted a drinking problem, 29 signed up for rehabilitation services. The authors blamed this on a policy that requires commanders be notified when a soldier enrolls in alcohol-abuse treatment programs.

I cannot provide any suggestions on how to change a tradition of pretentiousness in the Army: A solider pretending that nothing is wrong while turmoil rages inside his mind. Soldiers are expected and trained to be strong, to not be afraid, and to face their fears. Many of them when on active duty exemplify that attitude. However, working as a soldier is just that – it's work. Just like accountants or editors who are trained in their field, soldiers are trained in their jobs. When a soldier returns from duty, he is a normal human being like the accountant that clocks out at 5 in the evening. Perhaps that analogy might explain how a  soldier struggles with these problems when he is "off the clock," so to speak.

The emergence of mental health issues among soldiers – not just PTSD but also forms of abuse: drug, alcohol, violent – shows that the military needs to engage in preemptive action to combat these problems before they arise. (The puns were not intended, but I thought they were somewhat clever.)

Blog worth checking out

Holly Finch’s blog “Am I Still Me?” is worth taking a look at. She was a survivor in the London bombing that occurred on July 7, 2005 and as a result, blogs about her daily life while suffering from PTSD.

She recently blogged about coming off citalopram (U.S. trademark name: Celexa) and is experiencing some awful withdrawal effects. This makes me glad that I skipped Celexa in the hospital before I met my doctor. He recommended Effexor instead.

Not that it makes a difference really. I just had the privilege of not having two withdrawal symptoms in succession.